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Old May 8th, 2011, 06:09 PM
Ericmpls Ericmpls is offline
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LRS Treatment (Kidneys)

My Shih tzu (around 9 years old)quite eating for abt 5 days and was diagnosed with Chronic Kidney disease Wednesday, he is back from the Hospital and his levels dropped from
BUN from 97 to 50
CREA from 4.7 to 2.9
PHOS from10 to 4.8

****He still doesn't have his appetite back as of today, he's on the KD renal food now and is taking a appetite stimulant???

Back in November he was diagnosed with Hip Disp. and his Kidneys and Liver were tested for Meds and they were fine.

My Vet said ongoing treatment for the Kidneys(not including his Hip meds) will be arnd $230 month - I'm trying to drop that by buying some of the meds online IE Azodyl / LRS treatment 2-3 times weekly. I noticed there are a few sites online selling the LRS solution for about 75% less then my Vet.
***Any recommendations on which company to buy from??

***Also what size(gauge) needle?? My vet gave me a 1' needle with a blue hub but I don't know the gauge???
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Old May 8th, 2011, 06:50 PM
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growler~GateKeeper growler~GateKeeper is offline
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Welcome to the forum, nice drop on the numbers , now the trick is to keep them around that level without shooting up too high again.

Have you tried anything other than/or in addition to meds to stimulate his appetite? Does he have a favorite food/treat he goes nuts for? Freeze dried treats such as Pure Bites is a healthy option that will not affect the phos levels too much, especially the chicken, this can be crumbled & sprinkled on the food to entice him to try it.

Sitting beside him while he eats may also help, hand feeding if necessary - the most important thing at this point is getting him to eat.

Is he nauseous? Licking his lips often? Standing over the water bowl but not drinking?

What is his energy level like? Still want to go for walks?

For the fluid supplies have you checked the prices at your local pharmacy/walmart?

Have a look around for a local medical supply company, one that supplies hospitals/pharmacies/doctors offices etc some will do in house sales when they know the purpose or if you have a prescription from your vet. That is where I purchased my fluid supplies from, the company I used allowed off sales for CRF clients and is listed on the site below under Canada, of course it would be cheaper for you to find a company in your area to save on the cost of shipping/hassle of customs importing across country borders.

This is geared towards cats w/CRF but the supplies pages applies to both cats & dogs http://www.felinecrf.org/obtaining_supplies_cheaply.htm

Be sure that if you do purchase fluids online that you get the exact same solution as from your vet, there are many types of fluids that are used for subq injections and some have additives that may not be appropriate for your dogs' situation.

The Blue Hub needles would be 23g you can verify this by looking at the side of the hub it should be printed right on it. 23g is a good size for a dog of that size, though you could go to a slightly bigger size if you feel this is flowing to slow for his liking (if he squirms too much, gets restless during the treatment cuz it takes too long), I was using a 21g Ultra Thin Wall from Terumo on my cat.
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Old May 8th, 2011, 07:09 PM
Ericmpls Ericmpls is offline
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Thank you for your reply, he was licking his lips alot b4 I took him in - but now not at all - he drinks water alot - no problem with that - they think but not sure he may have an ulcer so he is on pepcid ac and Sucrafate. (he is not nausea) Vet told me no more of his favorite soft treats - so I got milkbones - he is eating them -

For appetite he is on 7 grams a day of mirtazapine as a slurry

His energy level is up and down - today / yesterday I gave him 250ml of LRS and his energy level was way down all day.

I boiled chicken breast with rice today and he ate about 8 oz of the chicken - he is acting like he is hungry (he goes to the KD food and keeps smelling it but walks away - he was eating it on Friday - He has always been very picky on dog food b4 the kidney problems
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Old May 8th, 2011, 07:14 PM
Ericmpls Ericmpls is offline
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it was a green hub - it said 18 on the side
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Old May 8th, 2011, 07:19 PM
Ericmpls Ericmpls is offline
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he was on carprophen and switched it to tramadol / also he is on Dasuquin and Wellactin for hips but I am not given him anything for his hips until he starts eating more
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Old May 8th, 2011, 07:27 PM
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Both carprofen and tramadol can cause kidney problems, so make sure you talk to your vet about starting them up again.

Sort of a side issue right now, considering the kidney management takes precedence, but how severe was the HD? It might be that the Dasuquin, Wellactin, and moderate exercise (esp. low impact exercise like swimming) will be enough to keep your boy limber. Weight is likely not an issue right now, but if you can keep him on the light side of normal, that will also be beneficial for his hips. With luck, maybe the HD can be managed from here on out without having to resort to the meds that might further impact his kidney function.
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Old May 8th, 2011, 07:35 PM
Ericmpls Ericmpls is offline
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Old May 8th, 2011, 07:47 PM
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It sounds like you are using Monoject brand needles? - a green hub is 18g. For a Shih Tzu you could use anything from 18-23g the 23g are about 1/2 the diameter of the 18g so the flow is much slower.

As mentioned I used Terumo Ultra Thin Wall 21g for a cat, the gauge you use depends on the comfort of your pet when the needle is inserted and how well your pet tolerates the length of time it takes for the fluid to flow.

If you find your dog flinches constantly when the 18g is inserted try a 20g or 21g, the flow rate will be slightly slower, but hanging the LRS bag above your head helps the flow rate.

Switching to Terumo Ultra Thin Wall will also reduce the discomfort of needle insertion because the walls of the needle shaft are much thinner than regular needles. This allows for both for faster flow and less of a pinch to the skin, the beveled edge aides in piercing skin smother and faster. Because the walls are so much thinner on the Terumo UTW the flow rate on a 21g was about the same as a Monoject 18g, but I didn't feel like I was stabbing my cat for each treatment.

He's probably not too interested in the smell of the KD food & that's why he's walking away from it. What food was he on before the kidney issues? Have you tried crushing a bit of milkbone ontop of the kd?
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Old May 8th, 2011, 07:10 PM
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Welcome to the board, Ericmpls. I don't know a lot about kidney disease, but I know a little about hip dysplasia and some of the meds frequently prescribed. Which meds is he on for the HD? If he was/is on NSAIDs did your vet say anything about stopping them? Some of them can be pretty hard on a dog's kidneys...

Sending along good wishes for you and your dog!
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